998 Chronic Non-indurative Nephritis. 



Symptoms. If the chronic disease has developed from the 

 acute form, the clinical picture of acute nephritis gradually 

 changes, its severe manifestations become less marked, and 

 finally the symptoms of chronic non-indurative nephritis are 

 established. In the great majority of cases, however, the 

 chronic nephritis develops from the start, its onset is insidious 

 and the symptoms of the disease are quite uncertain in char- 

 acter, so that a suspicion of the existence of the disease is 

 aroused only in a farther advanced stage of the process. 



In working animals attention is first attracted to the 

 diminution in the ability to work; the patients are easily 

 fatigued, out of sorts and languid, although on careful observa- 

 tion these symptoms may be recognized also in the other 

 animals. As the disease progresses emaciation becomes evi- 

 dent in spite of the fact that the appetite remains good or is 

 but slightly disturbed ; at the same time the mucous membranes 

 become more and more anemic. In some of the cases edematous 

 swellings form on the lower abdomen, on the chest and about 

 the feet or the thighs. 



Simultaneously with these symptoms, or even in their 

 absence, a diminution in the amount and an increase in the 

 specific gravity of the urine may be noticeable, and the urine 

 contains relatively much albumen, many renal elements like 

 hyaline, granular and possibly epithelial casts, fatty renal 

 epithelia and occasionally few red blood corpuscles. 



The daily amount, the specific gravity and the relative quantity of albumen 

 in the urine show great variations in the different cases. If the inflammation or 

 the edema retrogress for a time, the specific gravity may become nearly or quite 

 normal and the quantity of the urine may even be greater than normal. If the 

 chronic indurative inflammation approaches the stage of atrophy, the amount of 

 urine also increases, and in this ease permanently, while the quantity of albumen 

 at the same time becomes relatively lower. (In a case reported by A. Zimmermann 

 the amount of urine in a dog varied toward the end of the disease between 310 and 

 110 cc, the specific gravity between 1010 and 1032, and the urine contained albumen 

 constantly (0.05-0.1%), white blood cells and also amorphous detritus.) 



Sometimes the sensitiveness of the organ is increased and 

 it is enlarged, but as a rule examinations made in this respect 

 are negative. Many animals rise with difficulty and the effort 

 causes pain (Chouard). 



Occasionally inflammation of the serous membranes and of 

 the lungs supervenes and may have a fatal outcome. In the 

 absence of such complications symptoms of heart weakness 

 occur in the later course of the disease, or even from the onset ; 

 they may consist in pounding heart beat, soft, rapid pulse, 

 and finally the animals perish with signs of pulmonary or 

 laryngeal edema or of uremia. 



Course. The disease always runs a protracted course and 

 usually lasts several months. The clinical picture often shows 

 variations, and aggravations are observed especially after over- 



